静脉药物配置中心细胞毒性药物审方规则的建立与前置审核系统的实施  

Establishment of cytotoxic drug review rules and implementation of the pre-audit system in the intravenous drug configuration center

作　　者：黄晓英[1] 胡凌 陈添[1] 况迪 吴青[1] HUANG Xiaoying;HU Ling;CHEN Tian(Department of Pharmacy,Affiliated Children's Hospital of Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院药学部/儿童发育疾病研究教育部重点实验室/国家儿童健康与疾病临床医学研究中心(重庆)/儿童发育重大疾病国家国际科技合作基地/儿科学重庆市重点实验室,重庆市400014

出　　处：《临床合理用药杂志》2021年第16期29-31,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的建立静脉药物配置中心(PIVAS)合理的审方规则与前置审核系统,规范细胞毒性药物的合理使用。方法根据药品说明书及相关用药指南和专业资料,完善医院细胞毒性药物的审方规则。结合PIVAS审方软件,将细胞毒性药物的审方规则运用于PIVAS审方系统中,设置前置审方系统。药师根据系统审核情况,进行针对性的二次审核,以确保医嘱的准确性和合理性。比较审方前置规则建立与实施前后不合理医嘱审核情况及审核时间。结果审方前置规则建立与实施前(2017年1-12月)审核细胞毒性药物处方40682例,审方前不合理医嘱211例;审方前置规则建立与实施后(2018年1-12月)审核细胞毒性药物处方37707例,审方前不合理医嘱168例,不合理医嘱下降20.38%。审方前置规则建立与实施后处方拦截率高于审方前置规则建立与实施前(χ^(2)=4.854,P=0.028),出科差错率低于审方前置规则建立与实施前(χ^(2)=4.635,P=0.031)。与审方前置规则建立与实施前比较,审方前置规则建立与实施后平均每天处方审核时间节约15.2 min。结论PIVAS细胞毒性药物审方前置规则的建立,可提高药师审核医嘱的效率,对不合理医嘱在调配前拦截,防止给药差错,提高临床用药的安全性和合理性。Objective To establish reasonable review rules and pre-review system for the Intravenous Drug Allocation Center(PIVAS),standardize the rational use of cytotoxic drugs.Methods According to the drug instructions and related medication guidelines and professional information,improved the rules for review of cytotoxic drugs in hospitals.Combined with the PIVAS review software,the review rules for cytotoxic drugs were applied to the PIVAS review system,and the pre-review system was set up.The pharmacist conducted a targeted secondary review based on the system review situation to ensure the accuracy and rationality of the medical order.Compared the review of unreasonable medical orders and review time before and after the establishment and implementation of the review party’s pre-rules.Results 40682 prescriptions of cytotoxic drugs were reviewed before the establishment and implementation of the pre-examination rules(January-December2017),and 211 cases were unreasonable medical orders before the examination;After the establishment and implementation of the pre-review rules(January-December 2018),37707 cases of cytotoxic drug prescriptions were reviewed,and 168 cases were unreasonable medical orders before the review,and irrational medical orders decreased by 20.38%.The prescription interception rate after the establishment and implementation of the pre-reviewer rules was higher than that before the establishment and implementation of the pre-reviewer rules(χ^(2)=4.854,P=0.028),and the error rate of the department was lower than that of the pre-reviewers before establishment and implementation(χ^(2)=4.635,P=0.031).Compared with the establishment and implementation of the pre-review rules,the average time for prescription review per day after the establishment and implementation of the pre-review rules saved 15.2 minutes.Conclusion The establishment of pre-examination rules for PIVAS cytotoxic drugs can improve the efficiency of pharmacists’review of medical orders,intercept unreasonable medical orders before depl

关 键 词：细胞毒性药物 静脉药物调配中心 审方前置 

分 类 号：R95[医药卫生—药学]